Carrie Ann Randle, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP17359 Issued in CA

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(619) 532-8109

NPI assigned

Sep 14, 2007

Last updated

Mar 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Somagen Healthcare IncGroup PAC ID 1557530151, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Somagen Healthcare Inc

  dba AFC Urgent Care San Diego

  • Urgent Care Clinic/Center
  • Santee, CA
  • NPI 1396058137
  Medicare reassignment Care Compare group
• Rady Children's Hospital San Diego

  dba Rady Children's Specialists of San Diego, A Medical Foundation

  • Pediatrics Physician
  • San Diego, CA
  • NPI 1669617197
  Medicare reassignment NPD
• Rady Children's Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD
• Somagen Healthcare Inc

  dba AFC Urgent Care Granada Hills

  • Urgent Care Clinic/Center
  • Granada Hills, CA
  • NPI 1043667660
  NPD
• Somagen Healthcare Inc

  dba AFC Urgent Care San Diego

  • Urgent Care Clinic/Center
  • San Diego, CA
  • NPI 1992237127
  NPD
• Asante

  dba Heimann Cancer Center

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  NPD
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  NPD
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  NPD
• Grossmont Emergency Medical Group

  • Emergency Medicine Physician
  • La Mesa, CA
  • NPI 1861437501
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711238400000",
    "number": "1558557348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921342170",
            "telephone_number": "619-532-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-8109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234223",
            "country_code": "US",
            "telephone_number": "858-966-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDLE",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2024-03-24",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP17359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN639033",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Elise Randall
• Riley Randel
• Andrew Singh Randhawa
• Kelly Randich, DPT
• Brittanee Randle, RN
• Dae'Avion Randle
• Erin Elizabeth Randoll
• Breeauna Randolph
• Paul William Randolph, PSY.D.
• Mitchell Gary Rands

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.